Child Development

Question 1

when babies feel secure what do they release and what is the importance of this?

Answer 1

hormone called oxytocin. This acts like a fertiliser for their growing brain, helping them to be happy babies and more confident children and adults. Holding, smiling and talking to your baby also releases oxytocin in you, which helps you to feel calm and happy

Question 2

how can you help the growth of the baby’s brain during pregnancy?

Answer 2

During pregnancy, your baby’s brain is growing very quickly. You can help this growth by taking some time out to relax and talk to them, to stroke your bump and maybe play some music.

Question 3

after baby is born how can you help baby’s development and attachment?

Answer 3

hold them against your skin as soon as possible and for as long as you want. This will calm them and give you both the chance to rest, keep warm and get to know each other. If you want to breastfeed, this is a great time to start, as your baby might move towards the breast and work out the best way to suckle. Breastfeeding also releases lots of oxytocin in baby and mother, which will help you to feel close and connected. If you choose to bottle feed, giving the first feed in skin contact while holding your baby close and looking into their eyes will also help you bond.

Question 4

how can you help understand your baby better?

Answer 4

Keep your baby close to you so that you start to recognise the signals they make to tell you they are hungry or want a cuddle. Responding to these signals will make your baby feel safe. Cuddling your baby next to your skin allows them to smell you and hear your heartbeat, which will comfort and calm them. This will also help you to feel calm and relaxed and will help with breastfeeding. Breastfed babies cannot be overfed, so you can use breastfeeding to soothe your baby and as a way of spending time together or having a rest whenever you both want.

Question 5

how can you support brain development and baby’s attachment throughout infancy?

Answer 5

Responding to your baby’s needs for food and comfort will not only support their brain development, but will also help them feel secure. This will help them to cry less, which makes your life easier too. Holding your baby when they are crying helps them to feel loved and secure, even if they don’t stop crying straight away. Research shows that babies who are responded to in this way grow into more confident toddlers who are better able to deal with being away from their parents temporarily, rather than becoming clingy and spoilt. This again can help make life less stressful for you

Question 6

how does the UK government define the early years?

Answer 6

0-2 years

Question 7

how does WHO define the early years?

Answer 7

0-3 years

Question 8

how does the education department define early years?

Answer 8

0-5 years

Question 9

how does the Scottish government define early years?

Answer 9

0-8 years

Question 10

what are the criticial days?

Answer 10

1001 days

Question 11

what does the 1001 days include?

Answer 11

• From conception to 2 years of age

Question 12

why is the 1001 days critical?

Answer 12

• Pregnancy and the first 2 years of life lay the foundation for cognitive (brain), emotional and physical development
  
  • This critical period of development comes at a time of significant vulnerability Pregnancy

Question 13

what are the important things in pregnancy which can impact baby?

Answer 13

• The start of child development
  
  • Maternal health critical for fetal / child development
  • The developing fetus susceptible to the in-utero environment
  • Infections: CMV, Rubella, Zika virus (from mosquitos)
  • Diet
  • Lifestyle factors: smoking, drinking, substance use, nutrition, stress

Question 14

how many connects per seconds are there in the fetus brain?

Answer 14

1 million

Question 15

what can maternal stress in pregnancy lead to?

Answer 15

Mothers stress level can have effect the development on the fetus in the womb and can have a higher chance of behaviour and emotional problems.

Question 16

why is early brain development important?

Answer 16

• Shaped by a cocktail of our genetics and our experiences in early childhood.
  
  • 0-3 years most rapid period of brain development
  • By our 3rd year 80% of our synaptic connections are made
  • Our experiences in early childhood define the wiring in our brains.
    Our emotional and physical health, social skills, cognitive and linguistic skills that develop during the first 2 years lay the foundation for future development.

Question 17

why is relationship with caregiver important for baby’s development and future?

Answer 17

• Babies are uniquely susceptible to their environment.
  
  • They are completely reliant on their caregivers.
  • Future development is heavily influenced by their attachments to significant adults.
  • Responsive, healthy and positive relationships with caregivers during these years lays the foundations for mental and physical health, makes babies feel safe and secure ready to explore and play, makes them ready to achieve at school and progress at work, enables them to develop positive relationships with others and to manage their emotions and behaviours.

Question 18

what does attachment theory suppose?

Answer 18

• Attachment theory supposes that children are predisposed to engage in social interaction

Question 19

what is secure base?

Answer 19

• Secure base: dependence fosters independence
  
  • We learn about ourselves and others from the outside in, through our interactions

Question 20

what does secure attachment help us to do?

Answer 20

• Regulate our emotions
  
  • Mentalize and empathise
  • Understand ourselves
    Understand others

Question 21

how does nature vs nurture impact development?

Answer 21

• Although our genetics provide the blueprint our experiences influence how and when genes are expressed. Epigenetics also impacts how genes are expressed.
  
  • An infant’s brain architecture is shaped by their experiences
  • The most important interactions come with those significant adults in their lives. Babies are hardwired for relationships- they prefer faces to other shapes, they can recognise familiar voices from birth, they
  • Responsiveness, skin to skin, holding a baby close, soothing them, responsively feeding, minimising cry are all essential
    Interaction and play is crucial for a baby

Question 22

what is serve and return?

Answer 22

• The experiences and relationship children have effects the development of the brain.
  
  • The most important parents can do to support brain development is get to know the child, read their cues, engage in serve and return interaction.
    Serve and return is like play. It goes birth directions. Baby makes an action or noise and the parent or individual copies them. The key is how they response.

Question 23

what does physical growth in the 1001 crucial days involve?

Answer 23

• Rapid period of physical growth
  
  • Birthweight can double by 6 months and triple by their 1st birthday
  • Can grow in lengths by approximately 40 cm
  Body systems develop and mature:
  • Musculoskeletal (MSK)
  • Respiratory
  • Cardiovascular
  • Gastrointestinal
  • Neuro

Question 24

what can a baby do by the age of 2?

Answer 24

• Walk unaided
  
  • Kick a ball
  • Climb on furniture
  • Use approximately 50 words

Question 25

when things are not okay what at the impacts on babies?

Answer 25

- Damaged early on can cause stress-related conditions in adult life such as heart disease and substance misuse. - Infants as young as 1 can experience trauma from witnessing things like domestic abuse. - High levels of stress in early childhood can be toxic to the developing brain.

Question 26

how many babies does domestic abuse effect?

Answer 26

39,000

Question 27

how many babies does mental health problems effect?

Answer 27

144,000

Question 28

how many babies does substance misuse effect?

Answer 28

109,000

Question 29

what percentage of babies in the UK have a parent affected by domestic violence, mental health problems or substance misuse?

Answer 29

26%

Question 30

high stress levels in pregnancy can lead to what?

Answer 30

double the risk of children developing mental health illness as teenagers

Question 31

Babies who are exposed to arguments, domestic abuse, neglect, lack of responsiveness (ambivalence), separation can do what?

Answer 31

change gene expression and have detrimental effects on brain development leading to an adaptation of the stress regulation systems can lead to irritability, difficulty in soothing, hyper anxiety, difficulties forming relationships with peers

Question 32

what can poor mental health affect?

Answer 32

- Diet - High blood pressure – preeclampsia, premature birth, low-birthweight - How we respond to stressful situations – increased incidence of smoking, drinking and substance use. - Bonding with baby

Question 33

what is high levels of stress during pregnancy linked with?

Answer 33

- Increased rates of congenital birth defects Cognitive / behavioural issues

Question 34

what are ACEs?

Answer 34

Adverse Childhood Experiences

Question 35

what are ACE's linked to?

Answer 35

- Health harming behaviours - Social determinants of health - Neurobiological and genetic pathways - ACEs linked to a variety of physical, mental and social health outcomes Studies show the more ACEs someone has, the greater the risk of impacts on health, but NOT an inevitability based on score

Question 36

what is developmental trauma?

Answer 36

- Trauma becomes stored in the body - Brain may become fear driven, and hypersensitive to particular triggers Higher brain function can become impaired

Question 37

what is GIRFEC?

Answer 37

means of promoting the rights of children and parents. - It aims to facilitate partnership working between families and relevant agencies in order to promote the wellbeing of all children in Scotland. Ensuring children receive the right help, at the right time from the right people.

Question 38

what does GIRFEC aims at being?

Answer 38

- Child focused - Based on an understanding of wellbeing of a child in their current situation - Based on tackling needs early Requires joined up working

Question 39

what is the evidence about adverse experience during childhood?

Answer 39

- There is clear evidence that adverse experiences during childhood negatively impact child development. - Gaps in development continue through life. - Experiences during the early years can increase the risk of developing poor physical and mental health in later life. - There is significant economic gain to be obtained through investment in the early years. - The cost of failing children during the early years are enormous.

Question 40

why should we have hope in relation to child development?

Answer 40

- The vast majority of children receive all they need to thrive from their family unit. - The aim is not to create perfect parents / carers. - Although a great deal of the brains architecture is shaped during the first 2 years of life brain development continues into adolescence and early adulthood. - The earlier we can intervene the better… BUT, we should never give up on anyone, ever.

Question 41

How to support parent and infants developing close and loving relationships as midwives?

Answer 41

- Trusting relationships- we know this is easier with continuity (Sandall et al 2016) * - Support, active listening, additional appointments if necessary - Bonding with bump, talking, singing, warm hands on bump touching baby- reducing stress hormones - Additional support- peer support, community groups, counselling, perinatal mental health, trauma specialists early intervention critical. - Support positive birth experiences - Skin to skin at birth - Support breastfeeding - Keep baby close- do not separate Birth debrief

Question 42

what are the barrier to skin to skin?

Answer 42

- Lack of parental awareness - Lack of staff education on the importance of this - Culture- baby needs to be wrapped - Equipment and sterile fields eg in theatre - High workloads - Staff shortages - Needing to free up beds - Documentation presses for information eg weights Visitors

Question 43

What are the benefits of skin to skin?

Answer 43

- Significantly more likely to begin life breastfeeding - Babies significantly more likely to be breastfeeding at 1-4 months - More likely to be breastfed exclusively - If SSC after C/S more likely to be breastfeeding at 1-4 months - Higher blood sugars - Beneficial cardio respiratory stabilisation (late preterm infants) - Skin-to-skin contact was related to reduced feelings of guilt and fear during birth, especially for women who had a caesarean section. - substantially reduce the risk of moderate-to-severe maternal postpartum depressive symptoms. - Less crying - Improved neurodevelopment smiling more at 3 months - Improved brain maturation - Reduced infections- microbiome - Less weight loss - More sleep - Reduced stress reaction to painful procedures Increased bonding/attachment higher levels of oxytocin - Reduction in mortality- up to 150,000 fewer global deaths of newborns- especially preterm or low birth weight babies-

Question 44

what is kangaroo mother care?

Answer 44

- Kangaroo mother care, which involves skin-to-skin contact and exclusive breastfeeding, significantly improves a premature or low birthweight baby’s chances of survival - Current World Health Organization (WHO) recommendations indicate starting kangaroo mother care only after the baby is stabilized in an incubator or warmer, which can take on average 3-7 days. - Kangaroo mother care is already known to be effective, reducing mortality by 40% among hospitalized infants with a birth weight less than 2.0 kg when started once they are clinically stable. However, this important new study provides new evidence to show a further 25% reduction when it is initiated immediately after birth,